The UK’s social care sector through the eyes of the cooperatives CASA and Leading Lives

Cooperatives offering health and social care services, deeply rooted in the Italian territory, are now emerging in the UK. Democratically run and worker-owned enterprise, the cooperative CASA, created in 2004 in North east of England that currently employs 750 people, and Leading Lives, formed as a part of a divestment program in July 2012 that currently employs over 500 people and supports 1200 vulnerable adults, are examples in the UK’s social care sector and are the object of this case study.

Care and Share Associates (CASA) was created in 2004 with a vision of becoming the UK’s leading employee-owned provider of quality domiciliary health and social care domiciliary support services to older and disabled people. ”The social enterprise sector had failed to deliver a serious alternative to the large private provider sector, and we wanted to correct that error”, declared CASA’s managing director, Guy Turnbull. It was therefore designed to be pioneering, and be a positive ethical force that contributed to the transformation of health and social services in the UK.

CASA has reached over £10m pa turnover, providing 16,000 hours of care a week across five territories, and generating a PBT of £350k. CASA supplies domiciliary care; their mission is to support people to live as independently as possible, for as long as possible, in their own home, through the supply of appropriate care by trained and experienced employees.

Mutuality is at the heart of CASA’s business. They recruit and invest in the long-term unemployed in low income communities and currently employ 750 people. They believe engaged workers-owners will provide highest quality care and low staff turnover. “We embrace the ‘co-production’ of health and social care services, and recognise the need to move away from the traditional commissioner/ provider split. In today’s UK, unfortunately, in the procurement arena, bigger enterprises are considered better. This way of thinking hurts smaller social enterprises. Health and social care is an increasingly precious and scarce resource and thus innovative approaches need to be deployed to ensure its impact is maximised”, concluded Guy Turnbull.

Leading lives, another cooperative involved in the care sector in the UK, was formed as part of a divestment programme “aimed at transferring internally provided local authority services into the independent sector. We chose the cooperative model, as it fits our wish to put employees, our main asset, at the heart of the decision making process and giving the opportunity to influence the creation and development of the new company”, says Lucy Humphrey, chairperson to the board of directors .

Leading Lives is a support service for vulnerable adults and their family carer(s). It predominantly support adults with learning disabilities, but also work with older adults and people with physical disabilities and a range of complex needs. Leading Lives provides support to individuals to access community based activities, in group living settings, to develop skills to live independently and pursue their personal ambitions. It also provides daytime support at a number of Community Hubs and overnight stays at residential short break units offering respite to the family carer(s).

“The cooperative model reflects the values that Leading Lives places on its staff and its unique relationship with its customers. The employees are involved in all aspects of the business. The board is made up of only employees that are voted onto the board by their colleagues and each unit has the opportunity to elect a team representative to sit and a ‘staff forum’ which feeds into the Board and is used to test ideas and new initiatives. This model fosters staff creativity and when leading lives does not have sufficient expertise on certain topics we consult local experts. (Legal, finance, human resources)”, adds Lucy Humphrey.

Leading Lives believes that the cooperative model works well with social care principles and that this has helped them retain their strong values for supporting vulnerable adults. The model allows them to utilize their resources to support community activities and needs, to support local projects, create jobs for local people and invest into local businesses. “We believe that employee ownership has not only a great impact on the services we carry out, but also is a great asset for our business as it attracts customers, employees and likeminded organizations. The cooperative model helps us work more efficiently and maximize our resources”, concluded Lucy Humphrey.

Leading Lives was recently named Health and Social Care Social Enterprises of the Year in the Social Enterprise UK 2015 Awards.

According to Sion Whellens from the UK cooperative movement, the context for social and health care cooperatives in the UK is one of political contestation and ever-increasing financial ’squeeze’. The UK state is progressively withdrawing from financing and directly delivering social care, at both national and local level. As a result, there is a gathering crisis in the provision of services for older and vulnerable people, particularly in poor towns and regions.

“The UK movement looks to Italy for lessons in how to respond to social need with a model based on cooperative co-production, but it does not have Italy’s established intersectional relationships with political parties, state agencies and trade unions. In the UK, the union movement - traditionally allied with the Labour Party - largely focuses on defending central and local state provision of services, and the conditions of state employees. It has tended to see cooperative social enterprise as a ’Trojan horse’ for the privatisation of public assets such as schools, hospitals and libraries, and reductions in workers’ wages and rights. This view may begin to change, as the crisis develops. Some efforts are also being made to improve union-cooperative understanding and joint working”, stands Whellens.

Another difficulty for the UK is the lack of financial infrastructure for cooperative development and investment. Start-up money can be raised through debt or the ’crowd funding’ of community shares (a tax efficient capital-raising mechanism available to UK Cooperative and ’Community Benefit’ Societies), but cooperatives have to compete directly with multinational, privately-financed businesses such as SERCO for contracts which require bidders to have large capital reserves.